Friday, August 31, 2012

Non-Hodgkin Lymphoma Prognosis and Survival Rate

The immune system of the body has crucial function to fight infection and disease. In people with lymphoma, their lymphatic system (it is part of the body’s immune system) is affected. As well we know, non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL or sometimes also familiar called as Hodgkin disease) is two common types of lymphoma cancer. Let’s focus to discuss the treatment, prognosis, and survival rate for NHL!

Like the network of blood vessels that distributes blood throughout the body, lymphatic system is also a kind of vessel network that carries fluid called lymph. And there are white blood cells what we call as ‘lymphocytes’ in the lymph. These lymphocytes are so essential to protect the body from a variety of infectious agents. But in patients with lymphoma, without unknown reason these white cells multiply uncontrollably and then result malignant cells that can be harmful for other tissues throughout the body!
Generally, NHL is more common than Hodgkin disease. In 2010, about 8,500 new cases of HL and about 66,000 new cases of NHL were diagnosed in the U.S.

Non-Hodgkin lymphoma treatment

The treatment is closely associated to the type, stage, age of patient, and the overall health of patient.

Sometimes, patients with non-Hodgkin lymphoma that don’t experience any symptom may not need any treatment. This usually occurs in patients who have indolent /nonaggressive NHL. For this case, a ‘wait & see approach’ is usually the common choice. But patient is usually asked by doctor to have regular checkups in order to monitor the progress of the disease.

And for patients with aggressive NHL or when the disease causes symptoms, the common options of treatment may include;

Radiation therapy

This treatment involves X-rays (high-powered energy beams). The radiation of X-rays is intended to remove /kill the harmful cancerous cells. It is also intended to shrink tumors.

Radiation therapy can be used in combination with other treatments, but sometimes it may also be effective to be used alone.

Chemotherapy treatment

This treatment is another option to kill cancer cells. In general, it is a kind of prescribed drug treatment that can be given by injection or orally. To kill the cancer cells, doctor may need to use multiple chemotherapy drugs, single chemotherapy drug, or in combination with other treatments.

Monoclonal antibody therapy

This treatment is intended to increase the ability /performance of the body’s immune system to fight the disease (particularly to help kill the cancer cells). It also can be used to reduce the progression of the cancer.

Stem cell transplant

In general, this procedure is purposed to take and save the healthy stem cells. And then patient will be directed to get higher doses of radiation /chemotherapy to kill and remove the lymphoma cells that are not killed by standard doses.

After there are no lymphoma cells, then the healthy stem cells will be injected /returned back into the body’s patient. These healthy stem cells may also be taken from a donor (related /unrelated donor).

Non-Hodgkin’s lymphoma prognosis

In the last few decades, the prognosis of patients with NHL has improved drastically. After getting the treatment, the 5-year survival average in children with NHL is about 90 percent - and about 63 percent for adult patients.

And for patients with HL, their outlook is much better. After getting the treatments, the 5-year survival rate is about 90 percent or greater for kids with HL, and about 80 percent for adults.

Furthermore, there are many patients who live with lymphoma in remission for a lot of years after the treatment.

The survival rate is closely associated with the stage of the disease. The following is a helpful table from The National Cancer Institute for the average 5-year survival:

And according to a published article on the official site of the American Cancer Society, other factors that can affect the survival rate of NHL are the age of patient, the spread of lymphoma, PS (performance status ‘how well patients can do their normal daily activities’), and the serum LDH level (high level of serum LDH means the fast-growing tumors or indicates that there are more tumor in the body).

These good and bad factors are important and useful for doctors to choose and plan the best treatment for their patient. A treatment plan that is also based on these factors is better than a treatment plan that is only based on the type and stage of lymphoma.

Each poor factor is marked /assigned by 1 point. Patients who have less poor factors are more likely to have better chance of 5-year survival rate than others who have more poor prognostic factors. Based on these bad and good prognostic factors, there are four major risk groups:

For patients who don’t have or only have one poor prognostic factor, they are categorized into ‘low risk group’.

For patients who have two poor prognostic factors, they are categorized into ‘low-intermediate risk group’.

For patients who have three poor prognostic factors, they are classified into ‘high-intermediate risk group’.

And for individuals who have four or five poor prognostic factors, they are classified into ‘high risk group’!